Organization · Type 2 NPI

Orthopedic and Sports Enhancement Center, LLC

Specialist · Bloomington, IL

NPI number 1003900820 Active

Practice location

2406 E Empire St
Bloomington, IL 61704-3630

Call (309) 663-9300 Map

Fax (309) 661-1670

Specialties and licenses

TaxonomyCodeLicense
Specialist Primary 174400000XNone listed
Orthopaedic Surgery Physician 207X00000XNone listed

Specialist: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

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About NPI 1003900820

Orthopedic and Sports Enhancement Center, LLC's National Provider Identifier is 1003900820, issued on Oct 3, 2006. The primary taxonomy on file is Specialist (174400000X), and the practice location is in Bloomington, IL. The record was last updated on Sep 12, 2017.